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Taiwan: Man hospitalized with tularemia with no known source of infection - first domestic case in country

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  • sharon sanders
    bump this

    Interesting comment at the bottom. This is the moderator: link

    Bacterial Diseases Moderator
    Professor of Medicine, Mayo Clinic School of Medicine and Science


    Please see these other tularemia outbreaks:

    Rabbit fever: Hundreds infected as outbreak grows in Sweden - 2019 (from rabbits) link

    CIDRAP NEWS SCAN: Plague cases in Mongolia; Foodborne tularemia cluster; PCV13 pneumonia illness - 2019

    CO: First human tularemia case of 2018 confirmed in Pueblo County

    MA: Tularemia, Martha's Vineyard - 2018

    CIDRAP NEWS SCAN: Dog-linked tularemia; Resistance in 'lonely' microbes; Measles vaccination gap - 2017

    CIDRAP NEWS SCAN: Antibiotic resistance at the Hajj; MERS in Riyadh; Plague cases; Cat-linked tularemia case; HPV vaccine impact; H5N8 in Belgium - 2017

    CIDRAP NEWS SCAN: MRSA bacteremia; WHO on Liberia probe; Zika vaccine trial; Senate confirms FDA Head; Tularemia in Australia - 2017

    CO: 2016 Tularemia

    MN: Spike in tularemia puts Twin Cities pet owners on alert - 2016

    and many more...please enter tularemia in our search function to obtain more outbreak history on this topic.

    Leave a comment:

  • Taiwan: Man hospitalized with tularemia with no known source of infection - first domestic case in country

    ************************************************** ***********
    A ProMED-mail post
    ProMED-mail is a program of the
    International Society for Infectious Diseases

    Date: Wed 8 Sep 2021
    Source: Taipei Times [edited]

    The Centers for Disease Control (CDC) reported yesterday [Tue 7 Sep 2021] the first local case of tularemia, a rare infectious disease also known as rabbit fever.

    CDC Epidemic Intelligence Center Deputy Director Guo ****-wei said the case is a man in his 60s who lives in southern Taiwan and has underlying health conditions, including hypertension, heart disease and kidney disease. The man had not visited another country, had not been directly exposed to animals and he does not have a pet, Guo said, adding that there are bushes and fish farms near his house, and wild cats are often seen in the area.

    The man sought medical treatment at a hospital for a fever, chills and diarrhea, and genome sequencing on the bacterial strain from his blood sample suggested a high similarity with the bacterium _Francisella tularensis_, which causes tularemia, so he was reported as a suspected case on [Tue 24 Aug 2021], Guo said. The man was diagnosed with tularemia after a 2nd test, his symptoms were relieved after treatment and he has been discharged from hospital, Guo said. The man's family members and close contacts have not displayed similar symptoms, Guo added.

    Tularemia was listed as a notifiable communicable disease in 2007 and the man is the first local case detected in Taiwan, he said. The first case of tularemia was imported from the US and reported in 2011, he added.

    CDC physician Lin Yung-ching said tularemia is a zoonotic disease, meaning it can be transmitted from animals to people, and it mainly affects rabbits, hares, and field mice and other rodents, but also other mammals. Tularemia is highly contagious and can spread from animals to people in several ways, including insect bites, such as ticks that have bitten an infected animal; or direct exposure to sick or dead animals, Lin said. People can also get infected through contaminated food or water, eating undercooked meat of an infected animal, or by inhaling airborne bacteria from contaminated soil, he said.

    Serious complications associated with tularemia include sepsis and if it is left untreated, the fatality rate can reach as high as 30 to 60%, Lin said, adding that it can usually be effectively treated using antibacterials.

    [Byline: Lee I-chia]

    Communicated by:

    [Tularemia ( has been reported in most countries of the northern hemisphere and most frequently in the Scandinavian countries, northern America, Japan, and Russia. The incidence is high especially in North America and the Nordic countries. Moreover, tularemia has more recently been reported from Turkey, Yugoslavia, Spain, Kosovo, and Switzerland. In countries with a relatively high incidence of the disease, the geographical distribution is uneven. The organism has also been found in China but this is the first locally acquired case reported.

    Tularemia can be transmitted by aerosol, direct contact, ingestion, or, as noted, ticks and biting insects. Inhalation of aerosolized organisms (in the laboratory or as an airborne agent in an act of bioterrorism) can produce a pneumonic form. Direct contact with, or ingestion of, infected carcasses of wild animals (such as cottontail rabbit) can produce the ulceroglandular, oculoglandular, oropharyngeal (local lesion with regional lymphadenitis), or typhoidal (bacteremia without focal site) form. Immersion in or ingestion of contaminated water can result in infection in aquatic animals.

    ProMED would appreciate further information from knowledgeable sources on the above incident.

    Although we have no evidence to support this, when an infection such as tularemia occurs in a country that has not reported local infection, some concern must be raised about a bioterrorism event. - Mod.LL